The value of preoperative platelet count in the prediction of cervical involvement and poor prognostic variables in patients with endometrial carcinoma
The value of preoperative platelet count in the prediction of cervical involvement and poor prognostic variables in patients with endometrial carcinoma
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DOI：
10.1016/j.ygyno.2006.05.034
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发表时间：
2006-12-01
影响因子：
4.7
通讯作者：
Kucukali, Turkan
中科院分区：
文献类型：
--
作者：
Ayhan, Ali;Bozdag, Gurkan;Kucukali, Turkan
目标。在子宫内膜癌患者中，特别是在宫颈受累方面，广泛评估术前血小板计数与预后因素之间的关系。方法回顾性分析155例子宫内膜癌患者的临床资料。在年龄、组织学类型（类子宫内膜与非类子宫内膜）、子宫肌层浸润深度、腹膜细胞学检查、LVSI和淋巴结转移方面无差异。然而，晚期（III期和IV期）、低分化肿瘤分级（3级）、宫颈和附件受累与术前血小板计数中位数显著较高相关。以血小板计数325.000/0为阈值，多因素分析显示宫颈受累（P = 0.008; OR = 1.84，95%CI：1. 00）。17-2.89）和存在高级别组织学（P = 0.014; OR = 2.23，95% CI：1. 18-4.23，对于3级疾病）与更高的血小板计数显著相关。在临界值326.000/mu l时，受试者操作特征曲线法预测宫颈受累的敏感性为42.3%，特异性为82.8%。术前血小板计数较高，即使在正常范围内（150.000-400.000/mu l），也可能反映子宫内膜癌患者的不良预后因素，如宫颈受累和高级别。此外，对于广泛子宫切除术的必要性，应考虑到较高的血小板计数。(c)2006年爱思唯尔公司All rights reserved.
Objective(s). To evaluate the relationship between preoperative platelet counts and prognostic factors extensively, among endometrial cancer patients, especially with respect to cervical involvement.Methods. One-hundred fifty-five patients with endometrial carcinoma, who underwent surgery as the initial treatment consisting peritoneal cytology, total abdominal hysterectomy, bilateral salpingo-oophorectomy, systematic pelvic-paraaortic lymphadenectomy, and omentectomy were retrospectively analyzed.Results. There were no differences with respect to age, histological type (endometrioid vs. non-endometrioid), depth of myometrial invasion, peritoneal cytology, LVSI, and lymphatic metastasis. However, advanced stage (stages III and IV), poorly differentiated tumor grade (grade 3), the presence of cervical and adnexal involvements were associated with significantly higher median preoperative platelet counts. Accepting 325.000/0 platelet count as a threshold value, multivariate analysis revealed cervical involvement (P = 0.008; OR = 1.84, 95% Cl: 1. 17-2.89) and presence of high grade histology (P = 0.014; OR = 2.23, 95% Cl: 1. 18-4.23, for grade 3 disease) to be significantly associated with higher platelet count. At a cut-off value of 326.000/mu l, 42.3% sensitivity and 82.8% specificity for the prediction of cervical involvement was observed under receiver operator characteristic curve method.Conclusion(s). Higher preoperative platelet counts, even in conditions with normal range (150.000-400.000/mu l), may reflect poor prognostic factors such as cervical involvement and high grade among patients with endometrial carcinoma. Also, the higher platelet count should be taken into consideration for the necessity of radical hysterectomy. (c) 2006 Elsevier Inc. All rights reserved.